Knee, Balance and Walking

Knee Sprain / Strain
Sprains refer to injuries of the ligaments (connect bone to bone) and strains refer to injuries of the muscles or tendons (connect muscle to bone). Sprains and strains occur from quick over-stretching of the tissues causing micro-tearing and subsequent injury. Swelling begins as part of the inflammation process, causing pain and difficulty with movement.

The first step in treating sprains or strains in the knee is to rest, ice and elevate it. With severe limitations in movement you should see our physical therapists right away. There are different levels of sprain or strain from mild to severe. In some cases, the tearing can be complete and even be in need of surgical repair.

How physical therapy helps
In most cases, physical therapy can effectively help you recover from a sprain or strain. We first evaluate the injured area to determine the extent of the injury and ensure that the ligaments or tendons are still intact. After we pinpoint the injured area, we formulate a treatment plan that will quickly relieve your swelling, pain and begin restoring range of motion.

The goal of physical therapy is to restore your normal range of motion and eventually restore normal strength. If you participate in sports or are very active, we work closely with you to make sure that we help you fully recover and can participate in those activities you love to do. Call us today to discover how we can effectively treat your sprains or strains.

About Meniscus Injury
The meniscus is a ring of cartilage on the lower part of the knee (the tibial plateau) that the end of the large femur bone rides on. The meniscus is responsible for providing cushioning and stability of the knee joint while guiding movement. It is connected on the outer edges to the thick ligaments around the knee. The inside part of knee (medial meniscus) bears more weight and often sustains more damage than the outside part (lateral meniscus).

The meniscus is supposed to be smooth to ensure good gliding of the knee when it is bending. With injuries, poor alignment or weak musculature, the meniscus can become bruised and even torn. The outside edges of the meniscus have more blood flow than the inner portions. This means, depending on the area were the damage is located the healing process can be slow.

Many times, meniscus injuries are mild to moderate and can be rehabilitated with physical therapy. However, at times surgical intervention may be necessary to clean and shave down the torn areas of the meniscus. Physical therapy is very important in the full recovery after this surgical procedure.

How physical therapy helps
Physical therapy is a very important part of recovering from a meniscus injury. Most injuries are mild and involve small tears, bruising or irritation. Physical therapy can pinpoint where there are limitations in movement of the knee joint and weakened musculature support. By pinpointing the mechanisms of injury, our treatments can focus on reducing your pain and swelling quickly. Then, we focus on improving your range of motion, joint mobility and strengthening to make sure your meniscus receives the necessary support.

If surgery is necessary, we work closely with your physician and the rehabilitation protocol. The primary focus is on eliminating swelling quickly, resolving pain, improving range of motion, restoring normal walking and strengthening the supporting muscles around the knee. We then show you what to do to maintain a healthy knee with physical activities and sports. Call us today to see how we can help you recover quickly from a meniscus injury.

About Knee Tendonitis
The ending of the word "itis" is defined as inflammation. Therefore, tendonitis is inflammation of a tendon, which connects muscles to bones. Commonly, the tendon that connects your quadriceps muscle to the tibia bone (quadriceps tendon above the kneecap and patellar ligament below the kneecap) can become inflamed resulting in a condition also known as jumper’s knee. This thick tendon runs over the top of your kneecap and attaches to the tibia bone below. This structure can often become inflamed due to abnormal joint movements, poor posture and weakness of the surrounding musculature. This causes strain to the tendon with resulting pain during repetitive movement and especially with squatting or kneeling down. Other areas of tendonitis in the knee can occur such as the back, outside or inside of the knee.

How physical therapy helps
Physical therapy is the first line in conservative treatment for tendonitis. Most tendonitis is due to underlying abnormal mechanics of movement, walking and weakness. Our trained physical therapists are experts in evaluating your movement to pinpoint the source of the trouble. Modalities may be used to alleviate pain and discomfort, while hands-on therapy improves joint mechanics and movement.

Finally, gentle strengthening exercises and joint coordination exercises help to restore stability to the affected area and prevent re-occurrence of symptoms. To discover how we can help your knee tendonitis call us today!

About Anterior Cruciate Ligament (ACL) Tears
The anterior cruciate ligament (ACL) is an important ligament that checks the forward sliding of the tibia bone on the femur bone in the knee. This ligament can be injured with sports or falls, especially with blows to the knee from the side, while the foot is planted on the ground.

The ACL can be sprained which means it is still intact. If ruptured it is completely broken. When an ACL injury involves a sprain, there is typically swelling that occurs in the knee and a feeling of instability with walking. Sprains are classified according to their severity, with grades 1 through 3. Grades 1 and 2 are often treatable without surgery, while grade 3 is most often a complete tear and typically requires surgery.

With a sprain, the ligament is overstretched and micro-tearing results, causing pain and inflammation. There is little blood flow to the ligaments and they get most of their nutrition from the joint fluid. This means, that their healing is a lot slower than most other tissues. Depending on the severity of the sprain and joint stability the potential for future injury can increase.

With grade 3 ACL tears, surgery is most likely needed to repair. Physical therapy is vital to the rehabilitation after this surgery. Recovery does take time and the goal is to protect the surgery site, maintaining stability while getting back into walking and eventually running.

How physical therapy helps
Our physical therapists work with patients of all ages, especially those who have sustained ACL tears through sports activities. We work closely with your physician to examine the stability of your knee after the ACL injury. There are specific tests that we perform to assess how stable the ligament is and what course of action is best to resolve your pain and return you to activities as soon as possible. Most grade 1 and grade 2 sprains can be rehabilitated without the need for surgery and our physical therapists will discuss your options.

If surgery is needed for your recovery, rest assured that you are in the right hands for your rehabilitation. We work closely with your physician's rehabilitation protocols. The priority is to manage your pain and swelling after surgery and gradually increasing your range of motion in the knee per your post-surgery protocol.

As time progresses, we work to gain your strength back in the knee, improve stability of the joint, get you back to walking normally and eventually back into advanced movements, including running. Call us today to discover how we can help you bounce back after an ACL tear.

About Posterior Cruciate Ligament (PCL) Tears
The posterior cruciate ligament (PCL) is an important ligament that checks the backward sliding of the tibia bone on the femur bone in the knee. This ligament can be injured with sports or falls, especially with blows to the front of the knee while the foot is planted on the ground.

The PCL can be sprained which means it is still intact. If ruptured it means it is completely broken. When a PCL injury involves a sprain, there is typically swelling that occurs in the knee and a feeling of instability with walking. Sprains are classified according to their severity with grades 1 through 3. Grades 1 and 2 are often treatable without surgery, while grade 3 is most often a complete tear and typically requires surgery.

With a sprain, the ligament is overstretched and micro-tearing results, causing pain and inflammation. There is little blood flow to the ligaments and they get most of their nutrition from the joint fluid. This means, that their healing is a lot slower than most other tissues. Depending on the severity of the sprain and joint stability the potential for future injury can increase.

With grade 3 PCL tears, surgery is most likely needed to repair. Physical therapy is vital to the rehabilitation after this surgery. Recovery does take time and the goal is to protect the surgery site, maintaining stability while getting back into walking and eventually running.

How physical therapy helps
Our physical therapists work with patients of all ages, especially those who have sustained PCL tears through sports activities. We work closely with your physician to examine the stability of your knee after the PCL injury. There are specific tests that we perform to assess how stable the ligament is and what course of action is best to resolve your pain and return you to activities as soon as possible. Most grade 1 and grade 2 sprains can be rehabilitated without the need for surgery and our physical therapists will discuss your options.

If surgery is needed for your recovery, rest assured that you are in the right hands for your rehabilitation. We work closely with your physician's rehabilitation protocols. The priority is to manage your pain and swelling after surgery, gradually increasing your range of motion in the knee per your post-surgery protocol.

As time progresses, we work with you to gain your strength back in the knee, improve stability of the joint, get you back to walking normally and eventually back into advanced movements including running. Call us today to discover how we can help you bounce back after a PCL tear.

About Medial Collateral Ligament (MCL) Tears
The medial Collateral ligament (MCL) is an important ligament that checks the side to side sliding of the femur bone on the tibia bone in the knee. This ligament can be injured with sports or falls, especially with blows to the outside of the knee while the foot is planted on the ground. It is common for the MCL to be injured along with the medial meniscus.

The MCL can be sprained which means it is still intact. Ruptured means it is completely broken. When a MCL injury involves a sprain, there is typically swelling that occurs in the knee and a feeling of instability with walking. Sprains are classified according to their severity with grades 1 through 3. Grades 1 and 2 are often treatable without surgery, while grade 3 is most often a complete tear and typically requires surgery.

With a sprain, the ligament is overstretched and micro-tearing results, causing pain and inflammation. There is little blood flow to the ligaments and they get most of their nutrition from the joint fluid. This means, that their healing is a lot slower than most other tissues. Depending on the severity of the sprain and joint stability the potential for future injury can increase.

With grade 3 PCL tears, surgery is most likely needed to repair. Physical therapy is vital to the rehabilitation after this surgery. Recovery does take time and the goal is to protect the surgery site, maintaining stability while getting back into walking and eventually running.

How physical therapy helps
Our physical therapists work with patients of all ages especially those who have sustained MCL tears through sports activities. We work closely with your physician to examine the stability of your knee after the MCL injury. There are specific tests that we perform to assess how stable the ligament is and what course of action is best to resolve your pain and return you to activities as soon as possible. Most grade 1 and grade 2 sprains can be rehabilitated without the need for surgery and our physical therapists will discuss your options.

If surgery is needed for your recovery, rest assured that you are in the right hands for your rehabilitation. We work closely with your physician's rehabilitation protocols. The priority is to manage your pain and swelling after surgery and gradually increasing your range of motion in the knee per your post-surgery protocol.

As time progresses, we work with you to gain your strength back in the knee, improve stability of the joint, get you back to walking normally and eventually back into advanced movements including running. Call us today to discover how we can help you bounce back after a MCL tear.

About Lateral Collateral Ligament (LCL) Tears
The lateral Collateral ligament (LCL) is an important ligament that checks the side to side sliding of the femur bone on the tibia bone in the knee. This ligament can be injured with sports or falls, especially with blows to the inside of the knee while the foot is planted on the ground.

The LCL can be sprained which means it is still intact. If it is ruptured it means it is completely broken. When a LCL injury involves a sprain, there is typically swelling that occurs in the knee and a feeling of instability with walking. Sprains are classified according to their severity with grades 1 through 3. Grades 1 and 2 are often treatable without surgery, while grade 3 is most often a complete tear and typically requires surgery.

With a sprain, the ligament is overstretched and micro-tearing results, causing pain and inflammation. There is little blood flow to the ligaments and they get most of their nutrition from the joint fluid. This means, that their healing is a lot slower than most other tissues. Depending on the severity of the sprain and joint stability the potential for future injury can increase.

With grade 3 LCL tears, surgery is most likely needed to repair. Physical therapy is vital to the rehabilitation after this surgery. Recovery does take time and the goal is to protect the surgery site and maintaining stability while getting back into walking and eventually running.

How physical therapy helps
Our physical therapists work with patients of all ages, especially those who have sustained LCL tears through sports activities. We work closely with your physician to examine the stability of your knee after the LCL injury. There are specific tests that we perform to assess how stable the ligament is and what course of action is best to resolve your pain and return you to activities as soon as possible. Most grade 1 and grade 2 sprains can be rehabilitated without the need for surgery and our physical therapists will discuss your options.

If surgery is needed for your recovery, rest assured that you are in the right hands for your rehabilitation. We work closely with your physician's rehabilitation protocols. The priority is to manage your pain and swelling after surgery and gradually increasing your range of motion in the knee per your post-surgery protocol.

As time progresses, we work with you to gain your strength back in the knee, improve stability of the joint, get you back to walking normally and eventually back into advanced movements including running. Call us today to discover how we can help you bounce back after a LCL tear.

About Total Knee Replacement
A total knee replacement surgery may be needed when the knee has suffered a significant trauma or due to severe arthritis. In a total knee replacement surgery, the ends of the femur and tibia bones, and backside of the kneecap are replaced. With a partial knee replacement either the end of the femur bone or tibia is replaced. There have been many advances in the technology of the total knee replacement prosthesis and procedures allowing for less invasive surgery and faster recovery times.

Typically people have suffered for a while before having surgery, leading to changes in walking, muscle strength and function. Physical therapy before surgery in general has shown to help with the speed and quality of recovery after surgery.

How physical therapy helps
Working with your physician's protocols, we coordinate a thorough rehabilitation program to get you back to normal walking as soon as possible.

Typically, you start physical therapy in the hospital the day after your procedure. After progressing from the hospital, it is very important to continue with outpatient physical therapy in our practice.

We complete the rehabilitation cycle, further restoring your range of motion via your physician's protocols, restoring normal walking, balance, knee coordination and alleviating pain. We ensure that we continue to reinforce safety precautions with your knee movement while you heal. The end result is being able to return to most normal activities pain-free. Call us today to learn more about our post-surgery rehabilitation program.

About Poor Balance / Risk of Falling
Did you know that one out of three adults aged 65 and older fall each year? Among older adults, falls are the leading cause of both fatal and nonfatal injuries. Our ability to balance when walking or moving can change for a number of reasons. As we age, there is a natural loss of balance due to slowing down of reflexes, muscle weakness and tissue changes. In addition, arthritis in the ankles, knee or hips can affect balance. Furthermore, any neurological changes such as Parkinsons Disease, spinal cord injuries, nerve injuries, back problems and much more can play a role in diminished balance.

Our ability to balance relies mainly on 3 factors. Our ability to perceive movement comes from the nerve sensors in our joints and muscles, our vision and the position of our head in space through the vestibular system in the inner ear. When any one of these factors is not optimum, our ability to balance is affected and our risk for falling greatly increases.

The good news is that there is a lot than can easily be done to improve your ability to balance, which improves your walking and makes the risk of falling significantly less.

How physical therapy helps
Physical therapy is the main treatment for poor balance and reducing the risk of falls. It begins with a thorough evaluation of your walking, balance, coordination, joint movement, range of motion and strength. In the case of neurological conditions, more testing is done to determine visual tracking and your vestibular system function, which contributes to your balance.

After discovering the root cause of your balance difficulties, we program a treatment plan that will improve your ability to balance, walk and negotiate many different uneven terrains such as grass, sand, stairs and more. In addition, if you use a cane or walker, we can instruct you in the proper use of that adaptive equipment. Physical therapy goes a long way to improving your balance and setting you on the safe path to enjoying activities you love. Call us today to learn more how we can improve your balance and walking!

About Knee Pain
The knee is the most complex joint in the body. It has to bear the weight of the body while moving through an incredible range of 130 degrees or more. When running the knee absorbs up to 6 times the weight of your body in force! In a lifetime, it is estimated that the average person will take over 216 million steps and walk 108,000 miles. With this amount of use, at times things can go wrong and lead to knee pain.

Most knee pain stems from the loss of what is called "accessory motions". Accessory motions are the knee's smaller movements that are sliding side-to-side, back and forth as well as spinning and rotating. Without consistent stretching and especially without being very active, the tissues around the knee become tight. In addition, if the muscles in the front or back of the knee become weaker, that can lead to more abnormal forces on the knee joint.

All of these problems lead to increased friction and wear on the knee. The normal response is one of inflammation that can be felt as pain in and around the knee. A good rule of thumb is that if your pain is achy, a lack of normal joint fluid flow is occurring as well as possible decreased circulation around the knee to the muscles and tissues. However, with sharp pain during movement, an area in the knee is being severely pressed upon and the movement of the joint is not normal.

How physical therapy helps
Physical therapy is one of the most important treatments for knee pain. Whether it is from a sports injury, tight musculature, altered joint mechanics or arthritis, we can help!

The first step is to pinpoint the exact mechanism of why your knee pain is occurring. We perform a thorough evaluation of your posture, knee motion, knee and hip strength, walking analysis and joint mobility. From this we can discover the main reason for your knee pain and formulate a treatment plan that will alleviate it quickly.

Our physical therapists perform hands-on therapy to improve your knee joint mobility, reducing pain quickly. Modalities such as ultrasound may be used to reduce swelling and pain. Specific exercises will be performed to enhance your leg strength and address any unbalanced muscles that are contributing to your knee pain. Call us today to find out how we can quickly and effectively alleviate your knee pain!

About Knee Post-surgery Rehab
Other types of surgeries for the knee are fracture repairs or ligament / tissue repair from trauma. The amount of force it takes to break bone means that the soft tissues around the knee are most likely significantly injured also. After surgery, due to limited movement, range of motion is lost as well as strength. Since walking is a very complex action of different muscles moving in a coordinated fashion, it can be difficulty to walk after a knee surgery.

How physical therapy helps
Physical therapy is an important part of the rehabilitative process after a knee surgery. Depending on your surgery and your physician’s protocols, we gently progress you through a structured rehabilitation program. The goal is to restore pain-free range of motion in the knee while maintaining surgery recovery protocols. Finally, walking coordination, balance and strength are improved so you can return to normal pain-free walking. Call us today to learn more about our post-surgery rehabilitation program.

Difficulty Walking
It takes us at least 12 months as a baby to learn the fundamentals of walking. It takes even longer to learn how to walk properly and eventually run. Walking is very complex and requires good balance, the ability to know where your joints are in space (proprioception), the ability to know how your joints are moving (kinesthesia), good range of motion and strength.

As we age, with declining activity or after an injury, walking can become difficult. With pain in the knee or hip, our walking pattern can change, leaving us with a limp and possibly back pain. Changes in posture can also be responsible for changes in walking patterns.

When walking patterns change, abnormal stresses and strains with everyday activities can be transmitted to areas it shouldn’t. For example, if you have knee pain and you begin to limp, the other hip and your spine now have to take double the weight. This can lead to pain and dysfunction in those areas also. The good news is that walking can be helped and our physical therapists are the experts uniquely trained to do so.

How physical therapy helps
One of the main specialties of physical therapy is helping people to walk normally. This takes a thorough evaluation of your range of motion, strength, walking patterns, balance and coordination. By discovering in what area you have difficulties we can paint a picture of why your walking is not as it should be.

We then coordinate an extensive, but easy to do treatment plan that will address your range of motion, pain, coordination, balance and strength. The end result is the ability to walk without the need of an assistive device such as a cane or walker, safely and smoothly. Call us today to discover how we can help you walk better!